Research Progress on the Mechanism of Huanji Zhixie Decoction in Improving Diarrhea - Predominant Irritable Bowel Syndrome of Liver Depression and Spleen Deficiency Pattern via Mediating the TP53-PI3K-AKT Signaling Pathway

Abstract

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a functional bowel disorder with chronic recurrent diarrhea, abdominal pain and abdominal distension as the core symptoms, accompanied by intestinal motility disorder, visceral hypersensitivity and abnormal intestinal mucosal barrier function. Its pathogenesis involves multiple levels including intestinal mucosal barrier injury, neuro-endocrine-immune (NEI) network imbalance, intestinal flora disorder and abnormal regulation of signaling pathways. In traditional Chinese medicine (TCM), the core pathogenesis of IBS-D is “spleen deficiency and liver hyperactivity, internal retention of dampness and turbidity”. Huanji Zhixie Decoction, a self-designed TCM compound prescription by Director Yu Tao for the clinical treatment of IBS-D, has the effects of soothing the liver and invigorating the spleen, relieving depression and eliminating dampness, stopping diarrhea and resolving stagnation. Its clinical efficacy has been initially verified, but the mechanism of action has not been fully clarified. The TP53-PI3K-AKT signaling pathway, as a key pathway regulating cell survival, proliferation, apoptosis and metabolism, plays an important role in the repair of intestinal mucosal barrier, regulation of intestinal motility and maintenance of inflammatory microenvironment homeostasis, and is closely related to the core pathological features of IBS-D. This paper systematically sorts out the modern medical research progress of IBS-D, TCM theoretical understanding and application basis of Huanji Zhixie Decoction, focuses on the mechanism of the TP53-PI3K-AKT signaling pathway in IBS-D and the regulatory effect of TCM compound prescriptions on this pathway, and finally points out the current research gaps and the research ideas of this subject, so as to provide theoretical basis and literature support for the mechanism research of Huanji Zhixie Decoction in the treatment of IBS-D.